Term
| What is a common urine flow status in an acute renal failure patient? |
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Definition
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Term
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Definition
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Term
| What are the three general catagories of acute renal failure? |
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Definition
prerenal
intrinsic
post renal |
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Term
| What is the general cause of prerenal ARF? |
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Definition
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Term
| What medications can cause hypoperfusion to the kidney (4)? |
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Definition
ACEI/ARB
diuretics
cyclosporin
NSAIDS |
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Term
| What drugs can cause acute interstsial necrosis? |
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Definition
methacillin
NSAIDS
PNC/Sulfa
allopurinol
cimetidine
rafampin
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Term
| What drugs can cause acute tubular necrosis? |
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Definition
IV contrast
antibiotics
cisplatin |
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Term
| What are the two general causes of acute tubular necrosis? |
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Definition
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Term
| Why can sepsis lead to ischemia in the kidney? |
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Definition
| vasodilation of periphery |
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Term
| What are the four general causes of intrinsic ARF? |
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Definition
Acute tubular necrosis
acute interstial necrosis
microvascular
glomerularnephritis |
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Term
| To get post renal ARF what must be true regarding the blockage? |
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Definition
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Term
| If you see a patient with anuria or a variation from time to time in urine flow, what cause of acute renal faiure should come to mind? |
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Definition
| post renal due to obstruction |
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Term
| In pre-renal ARF, why when the GFR goes down and Angiotenin increases and sympathetic innervation to correct GFR, does the GFR eventually go back down? |
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Definition
| the systems get overworked |
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Term
| What is true of the urine osmolarity and the urine sodium in an intrinsic cause of ARF? |
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Definition
urine osmolarity with be <250
urine sodium will be >20 |
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Term
| WHat is true of the Na fractional excretion in intrinsic versus prerenal cause of ARF? |
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Definition
intrinsic: >1
pre renal: <1 |
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Term
| The urine sodium is <10. What is the cause of ARF? Pre renal or intrinsic |
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Definition
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Term
| What is the urine creatine:plasma creatine values for prerenal and intrinsic cause of ARF? |
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Definition
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Term
| If the urine osmolarity is >500 what is the diagnosis of the cuase of ARF? intrinsic or prerenal |
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Definition
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Term
| What is the value of the plasma BUN:Creatinine in a prerenal and intrinsic patient with ARF? |
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Definition
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Term
| What are four factors that can cause increased BUN:creatinine ratio? |
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Definition
high protein meal
volume depletion (burns/GI)
obstruction
reduced plasm perfusion |
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Term
| What type of urinary sediment is seen in Acute tubular necrosis and what is true of the proteinuria? |
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Definition
muddy brown cast
lower proteinuria |
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Term
| What is true of the urinary sediment for prerenal ARF? |
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Definition
often benign
sometimes hyaline cast |
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Term
| What is the urinary sediment of glomerularnephritis? |
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Definition
red blood cell cast
higher proteinuria |
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Term
| What type of casts are seen with Acute interstial necrosis? |
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Definition
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Term
| What can be seen in a u/a of post renal ARF? |
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Definition
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Term
What are the three phases of acute tubular necrosis?
What is true of GFR in each stage? |
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Definition
initiation (decreased GFR)
maintenance (GFR levels off at a low value)
recovery (GFR increases) |
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Term
| In ARF, is mortality increased more when it is caused by ischemia or toxin? |
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Definition
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Term
| What is the main cause of death in patients with acute renal failure? |
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Definition
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Term
| What type of waves do you see on an EKG of a hyperkalemic patient? |
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Definition
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Term
| What would be seen in a blood smear of a patient with acute interstisial necrosis or microvascular artheroembolitic disease? |
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Definition
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Term
| What is the treatment for Acute renal failure when it starts? |
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Definition
IV fluids to restore volume and prevent recurance of hypotension
watch electrolytes
dialysis if it ARF becomes life threatening |
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